Infection and Drug Resistance (Nov 2017)

Right and left ventricular function in hospitalized children with respiratory syncytial virus infection

  • Horter T,
  • Nakstad B,
  • Ashtari O,
  • Solevåg AL

Journal volume & issue
Vol. Volume 10
pp. 419 – 424

Abstract

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Thorsten Horter,1 Britt Nakstad,1,2 Omid Ashtari,1 Anne Lee Solevåg1 1Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, 2Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Oslo, Norway Background: Extrapulmonary manifestations including cardiac dysfunction have been demonstrated in children with respiratory syncytial virus (RSV) infection requiring intensive care. The aim of this study was to examine cardiac function in hospitalized children with moderate RSV infection admitted to a regular pediatric ward. Methods: We used echocardiography to determine cardiac output, and right and left ventricular function in 26 patients (aged 2 weeks to 24 months) with RSV infection. The echocardiographic results were compared with s-troponin, the need for supplementary oxygen or noninvasive respiratory support, and capillary refill time. Results: The number of measured s-troponins (ten [38%] of the included children) was too low to assess differences between children with elevated levels and those with normal levels. There were no differences in cardiac function between patients receiving oxygen treatment or respiratory support and those who did not. Capillary refill time did not correlate with any of the echocardiographic parameters. Both left and right ventricular output (mL/kg/min) was higher than published reference values. All other echocardiographic parameters were within the reference range. Conclusion: Children with moderate RSV infection had an increased left and right ventricular output, and cardiac function was well maintained. We conclude that routine cardiac ultrasound is not warranted in children with moderate RSV infection. The role of an elevated s-troponin in these patients remains to be determined. Keywords: bronchiolitis, capillary refill time, child, echocardiography, respiratory syncytial virus 

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